Heel spurs facts
- A heel spur is a pointed bony outgrowth of the bone of the heel (the calcaneus bone).
- Heel spurs under the sole of the foot (plantar area) are associated with plantar fasciitis.
- Heel spurs can occur alone or be related to underlying diseases.
- Heel spurs are treated by measures that decrease the associated inflammation and avoid reinjury.
What is a heel spur? What are heel spur symptoms?
A heel spur is a pointed bony outgrowth of the bone of the heel (the calcaneus bone). They are attributed to chronic local inflammation at the insertion of soft-tissue tendons or fascia in the area. Heel spurs can be located at the back of the heel or under the heel, beneath the sole of the foot. Heel spurs at the back of the heel are frequently associated with inflammation of the Achilles tendon (tendinitis) and cause tenderness and pain at the back of the heel made worse while pushing off the ball of the foot.
How do heel spurs relate to plantar fasciitis? What causes heel spurs?
Heel spurs under the sole of the foot (plantar area) are associated with inflammation of the plantar fascia (fasciitis), the "bowstring-like" tissue stretching underneath the sole that attaches at the heel. Plantar heel spurs cause localized tenderness and pain made worse when stepping down on the heel.
Heel spurs and plantar fasciitis can occur alone or be related to underlying diseases that cause arthritis (inflammation of the joints), such as reactive arthritis (formerly called Reiter's disease), ankylosing spondylitis, and diffuse idiopathic skeletal hyperostosis (DISH). It is important to note that heel spurs may cause no symptoms at all and may be incidentally discovered during X-ray exams taken for other purposes.
How do health care professionals diagnose heel spurs?
Heel spurs are diagnosed based on the history of pain and tenderness localized to the area of bony involvement. They are specifically identified when there is point tenderness at the bottom of the heel, which makes it difficult to walk barefoot on tile or wood floors. X-ray examination of the foot is used to identify the bony prominence (spur) of the heel bone (calcaneus).
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Symptom of Heel Spurs
Pain in the heel can result from a number of factors. Abnormalities of the skin, nerves, bones, blood vessels, and soft tissues of the heel can all result in pain. Because of walking and daily movement, we are always at risk for injury or trauma to the heel area.
What is the treatment for heel spurs? Are there any home remedies for heel spurs?
Heel spurs are treated by measures that decrease the associated inflammation and avoid reinjury. Local ice applications both reduce pain and inflammation. Anti-inflammatory medications, such as ibuprofen (Advil) or injections of cortisone, are often helpful.
Orthotic devices or shoe inserts are used to take pressure off plantar spurs (donut-shaped insert), and heel lifts can reduce stress on the Achilles tendon to relieve painful spurs at the back of the heel. Similarly, sports running shoes with soft, cushioned soles can be helpful in reducing irritation of inflamed tissues from heel spurs. Infrequently, surgery is performed on chronically inflamed spurs.
What is the prognosis (outlook) of heel spurs?
The outlook is generally good. The inflammation usually responds to conservative, nonsurgical treatments. Infrequently, surgical intervention is necessary.
Is it possible to prevent heel spurs?
Treating any underlying associated inflammatory disease can prevent heel spurs.
Medically Reviewed on 9/15/2017
Kasper, D.L., et al., eds. Harrison's Principles of Internal Medicine, 19th Ed. United States: McGraw-Hill Education, 2015.